Are paediatricians failing at school?

he notion that paediatricians act in the interests of the child to facilitate optimal outcomes is well entrenched within the medical culture. From this perspective paediatricians act to provide curative interventions in reversible situations , and to provide assistance and support for those children with chronic conditions where a return to full functionality is improbable. There has however been a shift in the spectrum of child health problems seen by paediatricians in recent years. The previous sharp demarcation between readily reversible acute child health problems and the chronic conditions and disabilities of childhood have been supplemented by increasing numbers of children with special educational needs (SEN). Section 312 of the 1996 UK Education Act states that: " Children have special educational needs if they have a learning difficulty which calls for special educational provision to be made for them " Children with SEN are just as functionally compromised and in need of paediatrician support as those with organic pathology. Has paediatrics and the practice of paediatricians sufficiently adjusted to these changes? Are paediatricians sufficiently cognisant of the requirements of children with SEN to provide the supportive interventions that they so ably provide for those with organic pathology? Children with SEN are frequently first identified in early education settings or primary schools. The 1997 DfEE Green paper 1 points out that " schools currently identify 18% of children as having special educational needs of some kind ". School teachers are in an excellent position to identify such needs in children, as they see the child for prolonged periods each day. Experienced teachers have a finely tuned perspective on the range of normality. They meet the parents or car-ers, so understanding the social context of the child. The UK government has given high priority to ensure that children with SEN are enabled with appropriate service provision: " We want to focus on identifying the needs of children with SEN and placing them at the centre of service provision, rather than concentrating on the different statutory responsibilities of individual agencies " 2 Schools are held accountable for the education of children through legislation , yet struggle to meet the educational requirements for children with SEN. Only a few of the 18% of children with SEN have a medical component to this need, thereby requiring to be seen by a paediatrician. Approximately 2% are statemented. Schools seek assistance for medical assessments and reports in …